To the Editor: Insulin resistance (IR) and
features of the metabolic syndrome are often associated with nonalcoholic
fatty liver disease (NAFLD). Insulin resistance has been considered to be
essential for the development of NAFLD.1 However,
multiple mechanisms are involved in the pathogenesis of NAFLD.2 We
previously described a form of NAFLD among petrochemical workers, affecting
predominantly younger men, causing mild fibrosis and cholestasis.3,4 In the current study we evaluated the
relationship of IR to NAFLD among petrochemical workers.